Journal of neurotrauma最新文献

{"title":"<i>Letter:</i> Methodological and Reporting Considerations in the Comparison of Ventriculoperitoneal and Lumboperitoneal Shunting for Post-Hemorrhagic Hydrocephalus.","authors":"Chul Bum Cho","doi":"10.1177/08977151261486815","DOIUrl":"https://doi.org/10.1177/08977151261486815","url":null,"abstract":"","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":"8977151261486815"},"PeriodicalIF":3.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148874533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association Between Sleep and Emotional Functioning in Pediatric Mild Traumatic Brain Injury: A Scoping Review.","authors":"Caroline A Luszawski, Michelle M Luszawski, Amy M Bender, Melanie Noel, Keith Owen Yeates","doi":"10.1177/08977151261425214","DOIUrl":"10.1177/08977151261425214","url":null,"abstract":"<p><p>The primary aim of this scoping review was to summarize existing research on the association between sleep and emotional functioning in pediatric mild traumatic brain injury (mTBI). Topics of interest were: (1) whether the association differs in children with mTBI versus other children; (2) whether the association changes over time post-injury; and (3) the directionality of the association (i.e., whether unidirectional or bidirectional). A systematic search of the literature was conducted pertaining to studies conducted with children (ages 0-18) with mTBI. To be included, studies must have reported on the association of sleep and emotional functioning; any measures of the two factors were eligible for inclusion. APA PsycInfo, Embase, Ovid MEDLINE, Scopus, and SPORTDiscus were searched for relevant studies. A total of 922 studies were independently screened and reviewed, and a total of nine studies were extracted, which included 1254 participants (mTBI <i>n</i> = 1054, controls <i>n</i> = 173). Samples were drawn primarily from hospital emergency departments, concussion clinics, and/or sports medicine clinics but also included children recruited through a school/community concussion surveillance program. Six of the included studies were prospective, and three were cross-sectional. Four studies included control groups. Most included studies reported at least one significant association between sleep and emotional functioning, such that poor sleep and emotional difficulties were positively correlated. None of the included studies reported on whether the association differed between children with mTBI and other children. Additionally, no study examined whether the association changed over time, or whether sleep and emotional functioning had bidirectional relationships. The available evidence suggests that sleep and emotional functioning are associated in children with mTBI, but further research is needed to determine the directionality of the association and whether the strength of the association differs in children with mTBI.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":"1371-1386"},"PeriodicalIF":3.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147433461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cavum Septum Pellucidum Enlargement in Special Operations Forces Members Is Associated with Lifetime Exposure to Large Explosives.","authors":"Sara De Giorgi, Andrea Diociasi, Rehab N Khalid, Phoebe Degn, Katelyn E Rand, Seba Gabali, Ronald E Hirschberg, Scott F Sorg, Michael Lev, Rajiv Gupta","doi":"10.1177/08977151261424705","DOIUrl":"10.1177/08977151261424705","url":null,"abstract":"<p><p>Cavum septum pellucidum (CSP) is a common neuroimaging finding linked to repetitive head trauma, yet its relationship to blast exposure among the military population remains elusive. Here, we investigated whether lifetime exposure to different types of blast is associated with CSP morphology among Special Operations Forces (SOF) personnel. We retrospectively analyzed 323 SOF members from the Comprehensive Brain Health and Trauma Program at Home Base who completed high-resolution 3T MRI and the Blast Exposure Threshold Survey (BETS), which quantifies lifetime exposure to explosive weapons across five blast exposure count categories (BEC1-BEC5). CSP grade and length were assessed using validated criteria on coronal 3D T1-weighted Magnetization Prepared Rapid Gradient Echo scans. A CSP length-to-septum length ratio (CSP ratio) was calculated to adjust for anatomical variation. BEC1-BEC5 were log-transformed to correct skewness and are referred to as log-BEC1-5.Variance inflation factor analysis indicated low multicollinearity among predictors (log-BEC1-5 and age), and variable selection using Least Absolute Shrinkage and Selection Operator regression identified log-BEC5 (exposure to large explosives) as the only retained predictor. In fully adjusted models, only log-BEC5 remained significantly associated with CSP measures and was therefore the focus of subsequent analyses.Participants were stratified by BEC5 = 0 vs. BEC5 > 0, and associations with CSP measures were assessed using group comparisons, multivariable regression, and dose-response models.Among 323 participants (mean age 42.7 ± 8.8 years), 273 (84%) reported any BEC5 exposure. SOF members with BEC5 > 0 had significantly greater CSP presence (42.1% vs. 22.0%, <i>p</i> = 0.007) and longer CSP length (median 3 mm vs. 2 mm, <i>p</i> = 0.002). In age-adjusted models, BEC5 > 0 was associated with greater odds of CSP presence (OR = 2.58, 95% CI 1.26-5.25, <i>p</i> = 0.009) and a 1.45 mm increase in CSP length (<i>p</i> = 0.004). In continuous models, each one-unit increase in log-BEC5 was associated with a 0.31 mm increase in CSP length (<i>p</i> = 0.008) and a 0.0059 increase in CSP ratio (<i>p</i> = 0.008).These findings indicate a statistically significant association between cumulative exposure to heavy explosives and CSP enlargement, suggesting that CSP may serve as a potential imaging marker of blast-related neurotrauma.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":"1423-1432"},"PeriodicalIF":3.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147317334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health and Functioning Among Women with Brain Injury due to Intimate Partner Violence: Analysis of a U.S. National Sample.","authors":"Justin E Karr, Juan Lang, Hongbin Zhang","doi":"10.1177/08977151261425218","DOIUrl":"10.1177/08977151261425218","url":null,"abstract":"&lt;p&gt;&lt;p&gt;The health and functional consequences of brain injury due to intimate partner violence (IPV-BI) have been underexamined compared with neurotrauma due to sport- and military-related injuries in predominantly male samples. This study examined whether IPV-BI was associated with worse physical and mental health and missed work or school among women survivors in the general U.S. population. Participants included women respondents from the 2015 National Intimate Partner and Sexual Violence Survey who reported IPV (&lt;i&gt;n&lt;/i&gt; = 2922; &lt;i&gt;M&lt;/i&gt; = 48.4 years old, SD = 16.50, range: 18-100), categorized into three groups based on self-report of lifetime injuries due to IPV: women with IPV-BI (&lt;i&gt;n&lt;/i&gt; = 352), bodily injuries unrelated to the head (IPV-Body; &lt;i&gt;n&lt;/i&gt; = 540), and IPV history without reported bodily injuries (No Injury group; &lt;i&gt;n&lt;/i&gt; = 2030). Participants completed a phone survey including self-report questions on mental and behavioral health conditions and duration of missed work or school. The estimated prevalence of IPV-BI was 5.6% [95% confidence interval: 5.0%, 6.2%] among adult women in the U.S. population and 12.1% [10.9%, 13.2%] among adult women survivors of IPV. The three groups were compared using logistic regression on the prevalence of headaches (IPV-BI = 39.4%; IPV-Body = 28.0%; No Injury = 21.2%), chronic pain (IPV-BI = 48.6%; IPV-Body = 35.4%; No Injury = 26.1%), sleep problems (IPV-BI = 60.5%; IPV-Body = 45.5%; No Injury = 36.1%), post-traumatic stress disorder (PTSD) (IPV-BI = 84.4%; IPV-Body = 56.9%; No Injury = 22.0%), missed work (IPV-BI = 24.7%; IPV-Body = 18.1%; No Injury = 5.9%), and missed school (IPV-BI = 59.1%; IPV-Body = 35.2%; No Injury = 9.1%). Results are reported with an odds ratio (OR) as an effect size, with a 95% confidence interval. In unadjusted analyses, women with IPV-BI reported significantly higher odds of headache (vs. IPV-Body: &lt;i&gt;p&lt;/i&gt; &lt; 0.001, OR = 1.68 [1.20, 2.16]; vs. No Injury: &lt;i&gt;p&lt;/i&gt; &lt; 0.001, OR = 2.44 [1.86, 3.02]), chronic pain (vs. IPV-Body: &lt;i&gt;p&lt;/i&gt; &lt; 0.001, OR = 1.72 [1.25, 2.19]; vs. No Injury: &lt;i&gt;p&lt;/i&gt; &lt; 0.001, OR = 2.68 [2.06, 3.30]), sleep problems (vs. IPV-Body: &lt;i&gt;p&lt;/i&gt; &lt; 0.001, OR = 1.83 [1.33, 2.33]; vs. No Injury: &lt;i&gt;p&lt;/i&gt; &lt; 0.001, OR = 2.71 [2.08, 3.34]), PTSD (vs. IPV-Body: &lt;i&gt;p&lt;/i&gt; &lt; 0.001, OR = 4.11 [2.73, 5.48]; vs. No Injury: &lt;i&gt;p&lt;/i&gt; &lt; 0.001, OR = 19.26 [13.36, 25.16]), and missed work (vs. IPV-Body: &lt;i&gt;p&lt;/i&gt; &lt; 0.001, OR = 2.66 [1.92, 3.39]; vs. No Injury: &lt;i&gt;p&lt;/i&gt; &lt; 0.001, OR = 14.31 [10.57, 18.05]) and school (vs. IPV-Body: &lt;i&gt;p&lt;/i&gt; &lt; 0.001, OR = 1.48 [0.99, 1.96]; vs. No Injury: &lt;i&gt;p&lt;/i&gt; &lt; 0.001, OR = 5.21 [3.61, 6.80]) than both comparison groups. These group differences remained significant when adjusting for sociodemographic characteristics (e.g., age, race/ethnicity, education). When additionally adjusting for lifetime physical and sexual IPV severity, women with IPV-BI still had significantly higher odds of PTSD than the IPV-Body group (&lt;i&gt;p&lt;/i&gt; &lt; 0.001, OR ","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":"1400-1411"},"PeriodicalIF":3.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146227196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of Concussion-Like Symptoms in Women Recruited from the Community with a History of Intimate Partner Violence.","authors":"Charlotte Copas, Abigail D Astridge, Olivia Hannon, Beatriz Duarte Martins, Rhiannon Rowse, Christine Padgett, Gershon Spitz, Terence J O'Brien, Jennifer Makovec Knight, Silke Meyer, Zhibin Chen, Michael J O'Sullivan, Stuart J McDonald, Sandy R Shultz, Georgia F Symons","doi":"10.1177/08977151261425216","DOIUrl":"10.1177/08977151261425216","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Intimate partner violence (IPV) affects one in three women worldwide. Mild traumatic brain injury (mTBI, i.e., concussion) is a frequent yet overlooked and under-researched consequence of IPV. Persistent postconcussion symptoms (PPCS) include a constellation of debilitating physical, emotional, and cognitive symptoms affecting approximately 15-30% of mTBI patients. Risk factors of PPCS include female sex, a history of mTBI, and mental health conditions, all of which are prominent in IPV contexts. Therefore, victim-survivors may be at an increased risk for PPCS; however, the prevalence and possible contributing factors, such as nonfatal strangulation (NFS) and head trauma (HT), remain largely unknown in this population. This study assessed 153 community-recruited women, including 96 IPV victim-survivors (&gt;6 months postexposure to IPV) and 57 non-IPV controls. Participants completed structured interviews assessing medical history, concussion-like symptoms (Rivermead Postconcussion Symptom Questionnaire; RPQ), IPV (Composite Abuse Scale (Revised)-Short Form; CASR-SF), brain injury (Brain Injury Screening Questionnaire-7 + IPV module), and post-traumatic stress disorder (PTSD) symptoms (The PTSD Checklist for The Diagnostic and Statistical Manual for Mental Disorders-5; PCL-5). First, regression analyses were used to examine how individual risk factors (i.e., IPV exposure, mTBI, HT, NFS events, depression diagnosis, and probable PTSD) are related to concussion-like symptoms. Second, participants were grouped based on IPV and mTBI status: (1) healthy control (HC) (&lt;i&gt;n&lt;/i&gt; = 38), (2) mTBI with no IPV; non-IPV-mTBI (&lt;i&gt;n&lt;/i&gt; = 19), (3) IPV without mTBI; IPV (&lt;i&gt;n&lt;/i&gt; = 29), and (4) IPV with mTBI; IPV-mTBI (&lt;i&gt;n&lt;/i&gt; = 67) to compare RPQ severity across groups and symptom profiles (i.e., total, somatic, emotional, and cognitive). As an exploratory analysis, we applied International Classification of Diseases (ICD-10) postconcussion syndrome (PCS) symptom criteria to gauge how concussion-like symptom profiles in this cohort aligned with ICD-10 threshold levels. Overall, regression analysis revealed that IPV-mTBI, IPV-HT, and IPV-NFS were significantly associated with greater concussion-like symptoms, regardless of the number of times each event occurred, as were a history of depression diagnosis and probable PTSD. Non-IPV-related mTBI and HT were only associated at higher exposure (&gt;5 and &gt;10, respectively). Group comparisons revealed that the IPV-mTBI group exhibited greater RPQ severity across total, somatic, emotional, and cognitive symptom profiles compared to the mTBI and HC groups. Interestingly, the IPV and IPV-mTBI groups did not differ significantly, highlighting the nonspecific nature of concussion-like symptoms in this population. When applying the exploratory ICD-10 PCS symptom thresholds, significant predictors from the primary analysis were consistently associated, and the IPV-mTBI group showed a markedly higher proportion (74.6%) meet","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":"1387-1399"},"PeriodicalIF":3.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147458061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood Biomarkers for Identifying Epidural Hematoma in Patients Presenting with a Glasgow Coma Scale of 13-15: A Collaborative European Neurotrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) Study.","authors":"Katja Malmi, Dana Pisică, Iftakher Hossain, Mehrbod Mohammadian, Thomas van Essen, Teemu M Luoto, Stefania Mondello, Riikka S K Takala, Olli Tenovuo, Thijs Vande Vyvere, Rick Vreeburg, John K Yue, Andrew I R Maas, Kevin K W Wang, David K Menon, Virginia F J Newcombe, András Büki, Jussi P Posti","doi":"10.1177/08977151261430239","DOIUrl":"10.1177/08977151261430239","url":null,"abstract":"<p><p>Triage of patients with mild traumatic brain injury (mTBI) and possible isolated epidural hematoma (iEDH) remains a clinical challenge. Blood-based biomarkers are being integrated into mTBI management, but their ability to identify patients with iEDH is uncertain. In this prospective, multicenter cohort study from the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury study, which recruited between December 19, 2014, and December 17, 2017 (NCT02210221), we included 1,048 mTBI patients (Glasgow Coma Scale ≥ 13) with biomarker sampling and head computed tomography (CT) within 24 h of injury. We assessed six blood-based biomarkers-including glial fibrillary acidic protein (GFAP) and ubiquitin carboxy-terminal hydrolase L1 (UCH-L1)-for their diagnostic performance in identifying patients with mTBI and iEDH. Patients with other traumatic intracranial findings potentially requiring surgery were excluded. Of 1,048 patients (median age 46 years; 64% male), 38 (3.6%) had iEDH and 982 (94%) had negative CT findings. GFAP showed the highest diagnostic accuracy for iEDH (area under the curve 0.77; 95% confidence interval 0.71-0.83) and yielded a negative predictive value of 1.0 at a threshold of 0.19 μg/L. The addition of UCH-L1 did not lead to a significant improvement in diagnostic performance. No significant correlation was found between EDH volume and biomarker levels. In this large multicenter study, GFAP was the only biomarker that could adequately distinguish patients with iEDH from CT-negative cases. These results suggest that GFAP may serve as a tool to rule out iEDH in patients with Glasgow Coma Scale ≥ 13, supporting its use in identifying individuals unlikely to require acute intervention for intracranial injury.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":"1443-1455"},"PeriodicalIF":3.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147499348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AI-Aided Triage for GSWH: Validating an Interpretable HCT-Based Mortality Model.","authors":"Ali Mansour, Jordan Fuhrman, Ronald Alvarado-Dyer, Elena Badillo Goicoechea, Elaine Lo, Farima Fakhri, John Nugent, Harsh Desai, Molly Lawrence, Olga Pasternak, Paramita Das, Peleg Horowitz, Andrii Sirko, Michael Mansour, William Roth, Tracey Fan, Elizabeth Carroll, Christos Lazaridis, Fernando D Goldenberg, Maryellen Giger","doi":"10.1177/08977151261429994","DOIUrl":"10.1177/08977151261429994","url":null,"abstract":"<p><p>Civilian gunshot wounds to the head (GSWH) carry high mortality yet lack standardized, imaging-based triage tools. Because initial noncontrast head computerized tomography (HCT) is universally obtained but not leveraged with validated, rapid, and reproducible methods, we developed and evaluated an interpretable, attention-based multiple-instance learning (MIL) model to predict in-hospital mortality from the initial HCT. In a retrospective cohort at a single level I trauma center (May 1, 2018-October 31, 2023), we included consecutive adults (≥16 years) with GSWH who underwent HCT, excluding those dead on arrival or without HCT. Of 222 patients, 106 (47.8%) survived to discharge and 116 (52.2%) died. We used a stratified random split to create a development set (<i>n</i> = 168, 75.7%) and an independent test set (<i>n</i> = 54, 24.3%); the development set was repeatedly partitioned 100 times into training and validation subsets to quantify performance uncertainty, and each of the 100 models was evaluated once on the test set. The MIL algorithm produced a prognostic severity score with case-level interpretability via attention maps. On the independent test set, discrimination for mortality was high (area under the curve: 0.92, 95% CI: 0.87-0.94) with sensitivity 0.88 (95% CI: 0.78-0.97) and specificity 0.87 (95% CI: 0.74-0.96) at the optimal operating point. Attention visualizations consistently highlighted brainstem, deep midline, and ventricular injury in high-mortality predictions, aligning with established high-risk neuroanatomy. These findings demonstrate that an interpretable, HCT-based MIL model can deliver objective, reproducible risk estimates and transparent case-level explanations, supporting early prognostication and imaging-first triage in penetrating brain injury.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":"1433-1442"},"PeriodicalIF":3.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147390151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genomic Signature Associated with Postconcussive Symptoms in Pediatric Mild Traumatic Brain Injury.","authors":"Brad G Kurowski, Lisa J Martin, Valentina Pilipenko, Anil G Jegga, Lisa Marie Langevin, Ken Tang, Ryan E Lamont, Miriam H Beauchamp, William R Craig, Quynh Doan, Stephen B Freedman, Jocelyn Gravel, Roger L Zemek, Keith Owen Yeates","doi":"10.1177/08977151261474338","DOIUrl":"https://doi.org/10.1177/08977151261474338","url":null,"abstract":"<p><p>Genetic contributions to the outcomes of pediatric mild traumatic brain injury (mTBI) are unclear. The current study applied a genomic signature approach to characterize biological processes critical to variation in persisting symptoms after concussion (PSaC). This planned substudy used data from a prospective cohort observational study, Advancing Concussion Assessment in Pediatrics. Participants aged 8-16.99 years with mTBI or orthopedic injury (OI) were recruited from five emergency departments in Canada between September 2016 and December 2018. Parents completed the Health and Behavior Inventory at 1 week, 1 month, and 3 and 6 months postinjury. Child saliva samples were used for DNA extraction and genotyping. The final genomic dataset included 122,701 variants in 17,212 genes. A systems biology analysis identified a case set of 26,642 variants in 2299 genes likely to be related to brain injury recovery. The same analysis identified a control set of variants/genes not enriched in any of the biological processes associated with brain injury recovery. Linear models examined the interaction between group (mTBI vs. OI) and genetic variant as a predictor of cognitive and somatic PSaC severity at the four follow-up assessments. To test for a genomic signature, we compared the number of nominally significant (<i>p</i> < 0.05) variants associated with group differences in PSaC in the case set to the number of associations meeting the same criteria in >10,000 matched runs of the control set. When the number of nominal associations in the case genes exceeded the 95th percentile expected by chance, they were considered enriched for genes/variants associated with PSaC severity. Participants included 967 children (633 mTBI, 334 OI; median [interquartile range {IQR}] age, 12.3 [10.5-14.3] years; 562 [58.1%] male); 891 provided a saliva sample, genotyping was completed for 720 samples, and 686 (462 mTBI, 224 OI) passed quality control. The aggregate signal from the gene-case set accounted for substantial variability in group differences in somatic symptom severity and modest variability in cognitive symptom severity, especially at 1-week and 1-month postinjury. Although the specific genes varied by symptom type and time postinjury, suggesting nonidentical genomic signatures, they shared overlapping biological processes. The findings demonstrate polygenic contributions to PSaC severity after pediatric mTBI. Specific genomic signatures vary by symptom type and time postinjury but share common biological pathways and processes. A better understanding of genomic contributions to pediatric mTBI outcomes should eventually yield more individualized management approaches.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":"8977151261474338"},"PeriodicalIF":3.8,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148829438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Helmet Use on Head Injury Characteristics and Medical Management Following Helmet-Relevant Activity-Associated Traumatic Brain Injury: A 2014-2021 National Trauma Data Bank Retrospective Cohort Analysis.","authors":"Austin Lui, Finnula Mageras, Alexander Olson, Su Phyu, Jen-Chieh Lee, Siddhe Patel, Abhiraj Sanku, Alexander Roeser, Alexander F Haddad, Phiroz E Tarapore, John K Yue, Michael C Huang, Geoffrey T Manley, Anthony M DiGiorgio","doi":"10.1177/08977151261481327","DOIUrl":"10.1177/08977151261481327","url":null,"abstract":"<p><p>Traumatic brain injury (TBI) is a major global health burden, with sports and recreational activities accounting for approximately 10% of all TBI cases in the United States. Helmets are widely used to mitigate head injury risk, yet prior studies have reported conflicting associations between helmet use and specific head injury patterns, medical management, and outcomes across different helmet-relevant activities. The objective of this study is to examine the associations between helmet use and head injury characteristics, injury severity, and emergency department (ED) disposition among patients with helmet-associated activity-relevant TBI. We conducted a retrospective cohort study using the National Trauma Data Bank (NTDB) research dataset (2014-2021). Patients with TBI resulting from cycling/motorcycling, skiing/snowboarding, roller-skating/skateboarding, and equestrian-related activities were included. Primary outcomes include TBI severity (based on Glasgow Coma Scale score), head injury severity scale (ISS) maximum score, loss of consciousness (LOC), intracranial hemorrhage (ICH), skull fracture, diffuse axonal injury (DAI), and ED disposition. Multivariable regression models were estimated using an inclusive analytic approach along with sensitivity analyses using complete-case analysis and multiple imputation for missing covariate data. A total of 174,892 patients were included, of whom 70,558 were helmeted and 97,606 were non-helmeted. In adjusted inclusive analyses, helmet use was associated with lower odds of more severe TBI (odds ratio [OR] = 0.60, 95% confidence interval [CI]: 0.58-0.61, <i>p</i> < 0.001), higher head ISS maximum scores (OR = 0.59, 95% CI: 0.58-0.60, <i>p</i> < 0.001), ICH (OR = 0.61, 95% CI: 0.60-0.62, <i>p</i> < 0.001), and skull fracture (OR = 0.35, 95% CI: 0.34-0.36, <i>p</i> < 0.001). Helmeted patients had slightly higher odds of LOC (OR = 1.06, 95% CI: 1.03-1.08; <i>p</i> < 0.001). To assess whether this association reflected increased rotational injury, analyses restricted to patients in the International Classification of Diseases, Tenth Revision (ICD-10)-era demonstrated that helmet use was associated with lower odds of DAI (OR = 0.87, 95% CI: 0.81-0.93; <i>p</i> < 0.001). Helmet use was also associated with substantially lower odds of high-acuity or adverse ED dispositions. Findings were consistent across inclusive, complete-case, and multiple imputation analyses. In conclusion, our findings suggest that helmet use in helmet-relevant activity-associated injuries is associated with reduced head injury severity, lower odds of ICH, skull fracture, DAI, and decreased need for high-acuity medical care. The observed increase in LOC among helmeted patients may reflect differences in reporting or injury biomechanics rather than greater injury severity. These findings support public health strategies to increase helmet use through policy, education, and advances in protective equipment design.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":"8977151261481327"},"PeriodicalIF":3.8,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148808727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Pericontusional Temporal Metabolomic Changes after Controlled Cortical Impact in Mice.","authors":"Amanda M Dave, Helena C Oft, Sambodh Sinha, Keri Janesko-Feldman, Vincent Vagni, Steven Mullett, Stacy Gelhaus, Patrick Kochanek, Robert S B Clark, Hulya Bayir, Dennis W Simon","doi":"10.1177/08977151261475262","DOIUrl":"https://doi.org/10.1177/08977151261475262","url":null,"abstract":"<p><p>Traumatic brain injury (TBI) is a leading cause of trauma-related morbidity and mortality, yet metabolic responses in the injured brain remain incompletely understood. Metabolomic profiling of pericontusional tissue may enable the identification of acute-phase biomarkers and reveal novel therapeutic targets. Using a controlled cortical impact (CCI) model, we performed targeted metabolomic analysis of tricarboxylic acid (TCA) cycle intermediates, amino acids, and acylcarnitines at multiple time points within the first 72 h postinjury. We hypothesize that there is time-dependent mitochondrial dysfunction and impaired β-oxidation in the acute and sub-acute time points after injury. CCI was performed in adult male C57BL6/J mice (velocity 5 m/s, depth 1.2 mm) under isoflurane anesthesia. Pericontusional tissue was harvested at 2, 6, 24, and 72 h postinjury following transcardial saline perfusion (<i>n</i> = 8/group). Naïve and anesthesia-only sham animals served as controls; sham animals received isoflurane exposure without craniotomy to isolate anesthetic effects from surgical injury. Relative quantification of TCA cycle intermediates, amino acids, and acylcarnitines was performed by liquid chromatography-high resolution mass spectrometry; metabolite abundances were normalized to protein content. Data were analyzed by Student's <i>t-</i>test, and <i>p</i> value < 0.05 determined significance. Enrichment analysis of metabolite profiles was conducted and visualized in MetaboAnalyst 6.0. Pericontusional tissue demonstrated time-dependent changes across the three metabolite classes, with two distinct temporal phases identified by dimensionality reduction: an acute phase (2-6 h) and a subacute phase (24-72 h). TCA cycle intermediates and glycolytic metabolites were broadly and progressively depleted, consistent with sustained mitochondrial dysfunction and energy failure. Acylcarnitines accumulated across multiple chain lengths, indicating impaired fatty acid β-oxidation. Amino acid profiles showed broad accumulation of essential and branched-chain amino acids-notably leucine and valine-alongside depletion of glutamate, alanine, and GABA, contrasting with prior reports of branch-chain amino acids depletion after TBI. Ingenuity Pathway Analysis confirmed broad suppression of amino acid catabolism, carbohydrate metabolism, and lipid oxidation pathways after CCI. Tryptophan catabolism via the kynurenine pathway was the sole upregulated metabolic pathway, consistent with indoleamine 2,3-dioxygenase 1-mediated neuroinflammatory signaling. We identified TBI-dependent alterations in key metabolic pathways within pericontusional tissue that may have implications for the development of biomarkers or metabolism-targeted therapies. Future investigations should explore cell type-specific metabolic changes and assess their correlation with clinically measurable metabolite levels.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":"8977151261475262"},"PeriodicalIF":3.8,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148712674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}